Shingles
Shingles is a viral infection caused by the varicella zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains dormant in the body and can reactivate years later, causing shingles.
Shingles typically presents as a painful, blistering rash that may also be itchy. The infection can last several weeks and progress through several phases. Only people who have had chickenpox or been exposed to the virus can develop shingles, though not everyone will.
The shingles vaccine can significantly lower your risk of developing the disease and is recommended for those at higher risk.
Vaccination is recommended for:
Adults aged 50 and over
Adults aged 18 and over with weakened immune systems
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What triggers shingles?
Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox. After you recover from chickenpox, the virus remains dormant in nerve cells near your spine and brain.
While some people never experience shingles, the virus can reactivate, sometimes decades later. The exact cause of reactivation isn’t fully understood, but it’s believed to be linked to a weakened immune system.
Shingles can occur at any age, but it is more common in people over 40. Most people only have it once, though repeat episodes are possible. Stress, which can weaken the immune system, is also thought to be a potential trigger. The best way to reduce your risk of shingles is through vaccination.
Is Shingles Contagious?
Shingles itself is not contagious, it’s a reactivation of the varicella-zoster virus already present in someone who previously had chickenpox.
However, the fluid from shingles blisters can transmit the virus to someone who has never had chickenpox or the chickenpox vaccine. In that case, they may develop chickenpox (not shingles) as a first-time infection.
Shingles is less contagious than chickenpox, and the risk of spreading it is low, especially if the rash is covered. Still, the best way to protect yourself is through vaccination.
What Are the Symptoms of Shingles?
Shingles can affect any part of the body, but most often appears as a painful, blistering rash on one side of the torso, typically around the waist, chest, abdomen, or back. In some cases, the rash may appear on the face, ears, mouth, or eyes, and in rare instances, it can affect internal organs.
The condition usually lasts between 3 to 5 weeks and progresses through several stages, including tingling or pain before the rash appears, followed by blisters, scabbing, and eventual healing.
Stages of Shingles
Early symptoms of shingles
The first symptoms of shingles usually last for 2-3 days or longer, and can include:
fever, chills and headache
having less energy than usual
general weakness or feeling generally unwell
nausea, vomiting or diarrhoea
areas of pain or burning, usually in a small area on one side of the body
sensation of tingling, numbness or shooting pain on the skin
pink or red blotchy patches or strips on one side of your body
The Rash and Blister Phase
Within 1 to 5 days after the first signs of shingles, such as pain, tingling, or burning, a red rash typically appears. This rash soon develops into fluid-filled blisters that may be itchy and uncomfortable. New blisters can continue to appear over several days, and the rash usually lasts between 10 and 15 days.
The blisters often form on the torso or face, typically in a single band on one side of the body, resembling a severe burn. They can also appear on the lower body in some cases.
During this phase, you are contagious. It's important to:
Keep blisters covered
Avoid swimming, sharing towels, or playing contact sports
Stay home and isolate if you’re unable to cover the rash
Not everyone develops a widespread rash. Some may have just a few blisters, and in rare cases, no rash at all.
Scabbing and Crusting
As the blisters heal, they begin to dry out, forming scabs or crusts. This process usually takes a couple of weeks. Once all the blisters have scabbed over, you are no longer contagious.
Other types of shingles
Because shingles can affect other parts of the body, there may be symptoms that are different to the typical shingles symptoms. For example:
Mouth shingles — facial tenderness, mouth or tooth pain, lesions on the hard and soft palate
Ear shingles — problems with balance and hearing, and muscle weakness on the side of the face
Eye shingles — pain, redness and swelling in and around the eye, temporary or permanent loss of vision
Internal shingles — no rash is present but the virus can affect internal organs such as the digestive system and the brain
Who is at risk of shingles?
Anyone who has had chickenpox can get shingles. However, some factors may increase your risk of developing the condition. These include:
Age: The risk increases significantly in people aged over 50 years
Compromised immune system: People with diabetes, cancer, HIV, AIDS or those taking medication to suppress the immune system are at greater risk
Chronic illness: Having illnesses such as type 1 diabetes, lupus, asthma, chronic obstructive pulmonary disease, and inflammatory disease increases your risk
Family history: Having had shingles in the past or a family history of shingles increases the risk of an outbreak
Stress: Stress and sleep deprivation have also been linked to an increased risk of shingles
Complications of shingles
Most of the time, people recover well from shingles. However, some complications can occur. These include:
infected rash requiring antibiotic treatment
long-lasting nerve pain known as postherpetic neuralgia (PHN)
inflammation of the brain or spinal cord, which increases the risk of stroke, encephalitis and meningitis
eye or vision problems, including loss of vision, if shingles affect the eyes
balance and hearing problems if shingles affect the ears
damage to blood vessels, increasing the risk of stroke
pneumonia
scarring of the skin due to the blisters, especially if they were scratched or infected
Who is at risk of shingles?
Anyone who has had chickenpox can get shingles. However, there are some factors that may increase your risk of developing the condition. These include:
Age: The risk increases significantly in people aged over 50 years
Compromised immune system: People with diabetes, cancer, HIV, AIDS or those taking medication to suppress the immune system are at greater risk
Chronic illness: Having illnesses such as type 1 diabetes, lupus, asthma, chronic obstructive pulmonary disease, and inflammatory disease increases your risk
Family history: Having had shingles in the past or a family history of shingles increases the risk of an outbreak
Stress: Stress and sleep deprivation have also been linked to an increased risk of shingles
Complications of shingles
Most of the time, people recover well from shingles. However, some complications can occur. These include:
infected rash requiring antibiotic treatment
long-lasting nerve pain known as postherpetic neuralgia (PHN)
inflammation of the brain or spinal cord, which increases the risk of stroke, encephalitis and meningitis
eye or vision problems, including loss of vision, if shingles affect the eyes
balance and hearing problems if shingles affect the ears
damage to blood vessels, increasing the risk of stroke
pneumonia
scarring of the skin due to the blisters, especially if they were scratched or infected
When should you see a doctor?
If you’re experiencing any of the early symptoms of shingles, you should visit your doctor. If it’s diagnosed within three days of the rash appearing, your doctor can prescribe an antiviral medication that is designed to shorten the length and severity of the illness.
You should also visit your doctor if:
your symptoms get significantly worse after treatment
symptoms don’t disappear after a few weeks
you develop new symptoms in addition to the rash
you experience fever, open wounds from scratching the blisters, or red streaks radiating from the blisters
you experience problems with your vision, hearing or balance
you have ongoing nerve pain after you have recovered
How do you treat shingles?
There is no cure for shingles, however, antiviral medication can reduce the severity and duration of symptoms. This medication may also prevent complications and lower the risk of a recurrence.
You can manage the symptoms of shingles by:
taking antiviral medication prescribed by your GP
using pain relief medication
applying cool, wet compresses to the blisters to relieve pain and itching
applying calamine lotion to your skin
taking colloidal oatmeal baths to reduce symptoms
reducing stress
getting plenty of rest and sleep
topical patches and numbing agents can also be used to relieve post-shingles pain (PHN), although these shouldn’t be used on unhealed blisters
Other measures you should take include:
avoid scratching the blisters to reduce the risk of breaking the skin and getting an infection
wash your hands often, especially after touching your rash
pat yourself dry after bathing or showering instead of rubbing
Can you prevent shingles?
The best prevention against shingles is to be vaccinated. The vaccine is recommended to everyone over 60 and is available free of charge for Australians aged between 70 - 79.
However, if you are concerned, speak to your doctor about whether this vaccine is right for you. While vaccination won’t provide 100% protection against developing shingles, it will reduce the likelihood.
Shingles can be painful and uncomfortable, but we are here to help.
Speak to your local MediADVICE pharmacist about your symptoms so we can recommend pain relief products and medications that may be suitable for you.
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Sources
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2Mayo Clinic, Shingles,https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054
3Australian Government Department of Health, Shingles (herpes zoster),https://www.health.gov.au/health-topics/shingles-herpes-zoster
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5Medical News Today, What is shingles?,https://www.medicalnewstoday.com/articles/154912#pictures
6Mayo Clinic, Shingles,https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20353054
7Healthline, Can Stress Trigger Shingles?https://www.healthline.com/health/shingles-and-stress
8Medical News Today, What are the early signs and symptoms of shingles,https://www.medicalnewstoday.com/articles/327416
9Medical News Today, What is shingles?,https://www.medicalnewstoday.com/articles/154912#pictures
10Healthdirect, Shingles,https://www.healthdirect.gov.au/shingles
11Healthdirect, Shingles,https://www.healthdirect.gov.au/shingles
12http://conditions.health.qld.gov.au/HealthCondition/condition/14/217/127/shingles-herpes-zoster
13Department of Veterans’ Affairs, Shingles vaccine now free for nearly 5 million Australians,https://www.dva.gov.au/news/latest-stories/shingles-vaccine-now-free-nearly-5-million-australians
14National Immunisation Program, Shield yourself from shingles,https://www.health.gov.au/sites/default/files/2023-11/shield-yourself-from-shingles-fact-sheet_1.pdf
15Know Shingles,https://www.knowshingles.com.au/
**https://www.health.gov.au/sites/default/files/2023-10/national-immunisation-program-shingles-program-advice-for-consumers_0.pdf
***https://www.health.gov.au/resources/publications/national-immunisation-program-shingles-program-advice-for-vaccination-providers